上颌窦感染患者内镜治疗的临床分析

Clinical efficacy of treatment of maxillary sinusitis under endoscopy

目的探讨鼻内镜下中鼻道开窗联合尖牙小视窗双径路术治疗上颌窦感染患者的疗效,为临床治疗上颌窦感染提供参考。方法选取医院2011年2月-2012年3月收治的128例上颌窦感染患者,随机分为两组,每组各64例,对照组单纯应用鼻内镜下中鼻道开窗术治疗,观察组同时联合尖牙窝小视窗双径路术治疗,对两组患者的治疗效果进行对照分析。结果临床治疗总有效率对照组为79.69%,观察组为93.75%,观察组患者明显高于对照组,差异有统计学意义(P<0.05);术前观察组患者的主观症状评分为(133.47±10.52)分、术后为(27.95±5.04)分;对照组术前为(132.52±10.69)分、术后为(41.76±6.31)分,两组患者主观症状评分均较治疗前显著下降,但观察组下降幅度明显优于对照组(P<0.05)。结论鼻内镜下中鼻道开窗术治疗上颌窦感染有效,但联合尖牙小视窗双径路术后,临床治疗效果明显增强,主观症状显著改善。

OBJECTIVE To evaluate the effect of endoscopic meatus fenestration combined with canine fossa small window dual pathways surgery on treatment of maxillary sinusitis so as to provide guidance for clinical treatment of maxillary sinusitis. METHODS A total of 128 patients with maxillary sinusitis who were treated in the hospital from Feb 2011 to Mar 2012 were enrolled in the study and randomly divided into the two groups, with 64 cases in each group; the control group received the single endoscopic meatus fenestration, and the observation group un- derwent the canine fossa small window dual pathways surgery; the therapeutic effect was observed and compared between the two groups. RESULTS The total effective rate of clinical treatment was 93. 75% in the observation group, significantly higher than 79.69% in the control group（P〈0.05）. The preoperative subjective symptom score was （133.47±10. 52） points in the observation group, （132.52 ±10.69）points in the control group; the postoperative subjective symptom score was （27.95±5.04） points in the observation group, （41.76±6.31） points in the control group;the subjective symptom score of both groups was significantly decreased after the treatment, however, it declined more significantly in the observation group than in the control group （P〈0.05）. CONCLUSION The endoscopic meatus fenestration is effective in treatment of the maxillary sinusitis; when it is combined with the canine fossa small window dual pathways surgery, the clinical therapeutic effect can be significantly intensified, and the subjective symptoms can be remarkably improved.